{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:09:31Z","timestamp":1789085371512,"version":"build-2803163510"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":71,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg Rep"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Meningiomas and intracranial aneurysms rarely co-occur and even less frequently present with acute subarachnoid hemorrhage (SAH) from aneurysm rupture. When anatomically adjacent, management requires nuanced decision-making.<\/jats:p>\n                  <jats:p>Observations We present an illustrative case and video of a ruptured distal anterior cerebral artery dissecting aneurysm causing SAH and intraparenchymal hemorrhage in a patient with an anterior fossa meningioma encasing bilateral optic nerves. The aneurysm location, morphology, and potential involvement of an eloquent parent vessel branch deemed endovascular embolization and parent vessel sacrifice unsafe. The meningioma directly contacted the aneurysm and its parent artery, rendering pre-resection securement unfeasible. We performed a single-setting, open, frontotemporal craniotomy with early Sylvian fissure dissection for proximal control, followed by systematic tumor resection and microsurgical clipping of the A2 dissection. Gross total resection of the meningioma with clip ligation of the aneurysm and preservation of parent vessel\/associated perforators was achieved. The patient returned to work 6 months postoperatively without persistent neurologic deficits. A narrative review of the literature on aneurysmal SAH associated with concomitant meningioma was conducted.<\/jats:p>\n                  <jats:p>Lessons This case highlights the intricacies of managing vascular and neuro-oncologic pathology presenting simultaneously in a patient in extremis, along with a literature review. The patient consented to the procedure and publication.<\/jats:p>","DOI":"10.1055\/a-2945-7117","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:36:15Z","timestamp":1789083375000},"page":"e144-e150","source":"Crossref","is-referenced-by-count":0,"title":["Managing Dual Intracranial Pathologies of a Ruptured ACA Aneurysm Presenting Concomitantly with a Large Anterior Fossa Meningioma: Illustrative Case with Operative Video and Literature Review"],"prefix":"10.1055","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6465-0964","authenticated-orcid":false,"given":"Aathmika","family":"Nandan","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine, The University of Toronto, Ontario, Canada","place":["Toronto"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin Z.","family":"Wang","sequence":"additional","affiliation":[{"name":"University of Toronto, Ontario, Canada","place":["Toronto"],"department":["Department of Surgery, Division of Neurosurgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Radovanovic","sequence":"additional","affiliation":[{"name":"University of Toronto, Ontario, Canada","place":["Toronto"],"department":["Department of Surgery, Division of Neurosurgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farshad","family":"Nassiri","sequence":"additional","affiliation":[{"name":"University of Toronto, Ontario, Canada","place":["Toronto"],"department":["Department of Surgery, Division of Neurosurgery"]},{"name":"MacFeeters Hamilton Neuro-Oncology Program, Princess Margaret Cancer Centre, University Health Network, Ontario, Canada","place":["M5G 2C4 Toronto"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"106128","DOI":"10.1016\/j.clineuro.2020.106128","article-title":"Association between intracranial aneurysm and meningiomas: an integrative survival analysis with identification of prognostic factors","volume":"198","author":"M R de Souza","year":"2020","journal-title":"Clin Neurol Neurosurg"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s10143-013-0477-7","article-title":"Surgical treatment of brain tumor coexisted with intracranial aneurysm--case series and review of the literature","volume":"36","author":"Z Zhong","year":"2013","journal-title":"Neurosurg Rev"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"396","DOI":"10.25259\/SNI_699_2024","article-title":"Concurrent meningioma and intracranial aneurysm: insights from an updated systematic review and a case report","volume":"15","author":"T Abou-Mrad","year":"2024","journal-title":"Surg Neurol Int"},{"issue":"08","key":"ref4","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.clineuro.2009.05.016","article-title":"Coexistence of cerebral aneurysm and meningioma--pure accident?","volume":"111","author":"B R Fischer","year":"2009","journal-title":"Clin Neurol Neurosurg"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.jocn.2017.07.032","article-title":"Strategy for patients with co-existence of meningioma and intracerebral aneurysm, especially unruptured aneurysm (-seven cases and review of the literature-)","volume":"45","author":"N Takeda","year":"2017","journal-title":"J Clin Neurosci"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"e04071","DOI":"10.1016\/j.heliyon.2020.e04071","article-title":"Feeding artery aneurysms associated with large meningiomas: case report and review of the literature","volume":"6","author":"K Papadimitriou","year":"2020","journal-title":"Heliyon"},{"issue":"26","key":"ref7","doi-asserted-by":"crossref","first-page":"2474","DOI":"10.1056\/NEJMoa1113260","article-title":"UCAS Japan investigators. 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